People in their later years often want to stay in their own homes. They are familiar spaces and full of familiar objects. Sometimes, however, the belief that being in the original home with everything staying the same is not a safe nor wholly accurate belief. At times people are actually more dependent on others in a home that is not modified or has had no actions taken to improve the way the person operates within the space. For some, the home might be making them more isolated or more stressed. It can often mean as much disruption and decision making to change a home for safety and to reduce clutter in the home environment as is felt when moving to a smaller and less cluttered home or unit Either of these options can improve any older person's life, but it's when they don't make decisions where problems start. Being clear about what is important for them as a person, so they can continue doing what they enjoy is a great start.
The more a person can make decisions about their environment, the more they will feel in control of their lives. However, it is important for them to be realistic about how they manage in life and what they need to feel safe and to function effectively. Sticking to a belief that their body will always work the same as it did when they were in their 60's is likely to lead to a point where nothing seems to be easy anymore and they constantly need to ask for help when they would prefer not to. Changing things in the environment can reduce those stressors and give back some freedoms. It's valuable for an older person, sometimes facilitated by a relative or friend, to look at their life and map out what they do, what they would like to do and how safe and comfortable they are with their activities. Such a map can reveal some truths of the impact their home has on their lifestyle.
For example, Hilda loves to play bridge with friends at a local community centre. She used to drive but because of various health changes no longer does so. To get to her twice weekly game she catches a taxi. This has worked for a while, but HIlda has recently started to find it too hard, has reduced to weekly only and is considering not attending anymore. If she was to stop going to bridge she would have no other contact with other people beyond an occasional family visitor and her shopping days. When she maps out what she does in her life, most of it revolves around being caught up in her home environment which is neither safe nor easy to manage.
She has a large garden area that she loves to tend but lately finds the work is less enjoyable. The constant work makes her so sore and tired that she is uncomfortable for 2 days afterward. She has cancelled her Tuesday bridge days because of the garden. On reflection, she can see that she loves to look at a nice garden and do some light pottering work, but not to tend it wholly on her own.
On Thursdays, to get ready to go to bridge, Hilda has breakfast, a shower, dresses and does her hair as she has always done. When she maps out what she does the effort it takes to achieve what seems to be a fairly simple process is clearer. Hilda always had her clothes in another room when her husband was with her. She liked to use it as a dressing room. This room is down 3 stairs. Her en-suite is small, without much light and no safety aids, but she uses it because 'you are meant to use an en-suite when you sleep in the master bedroom'. She is frightened in the shower so throws a towel on the floor of the shower to reduce the slip and holds onto the taps. She sometimes sits on the toilet seat, but has recently found the seat is cracked so has stopped doing that. She is exhausted from hanging onto things by the time she is dry, and has walked up and down the steps to get her clothing after the shower.
After showering and dressing, she goes down the steps again to have breakfast. Her kitchen has many appliances on the benchtops. She has been a keen cook throughout her life. She still does some baking but doesn't do the more complex processes of preserves making that she once did. She pushes a heavy appliance out of the way to turn on the electrical plug for the toaster, She pulls out 3 pieces of bread from a large loaf and proceeds to cut off pieces that are mouldy. After preparing her cereal from large boxes and a large container of milk, she slumps onto her kitchen chair and is quite puffed so takes a long time to eat breakfast. She sometimes falls asleep, making her even later. Then she goes back up the stairs, to the en-suite, to do her hair. The hair dryer is pulled out of the cupboard, and 5 other items she has stored fall out, so she picks them up. She holds onto the bench as she tries to blow dry her hair and starts to feel a bit dizzy, so flops down on the toilet seat.
Hilda walks back down to her kitchen table and picks up the phone to call the taxi. Then she realises the overnight storm has caused a large branch to drop across the driveway. She puts down the phone and decides Thursday bridge is too hard.
HIlda has identified that her lifestyle needs to have changes made, but the change she has decided upon, the decision to drop the social event that she loves, can potentially cost her greatly. Isolation and loneliness is a significant contributor to serious mental health problems and deteriorating general health in elderly people. Hilda has many options available to her to make life easier so that one of the most important aspects of her life can be maintained. Some of these are simply in the ways she does things around the house, some are about decluttering and simplifying within the house, others are about changing either the environment by adding safety apparatus or by changing where she sleeps, dresses, showers and stores things within the house. She also has the choice of moving to an environment that is well set up and easier to manage so that she has the energy to get back to bridge days.
For some older people, these decisions to change the home, are on balance as difficult to make as deciding to move house all together. Support to understand the types of changes that are available to them and to be clear about the impacts their homes have on their lives can make it easier for them to make small changes to each part of their home and life patterns, or to decide to remake their home in a new place. As with all things, older people need a bit of patience and a bit of prompting to recognise that changes for the better are possible and that help is available.
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